• B. FIT

Does Peeing Put a Damper on Your Workout?

As a trainer and cycle instructor, I have several clients who refuse to do jumping jacks, jump rope, or pedal out of the saddle in class. No, they aren’t lazy or unmotivated. These are confident, competent, fit women who work hard to get and stay in shape. So why do they shy away from certain exercises? Because they, like thousands of women, are scared of bladder leakage putting a damper on their workout—and their spirits.

“Urinary incontinence can affect every aspect of a woman’s life,” says Dr. Alex Runnels, OBGYN and owner of Scarlett Phoenix Cosmetic and Reconstructive Gynecology. “It can take her from being able to fully enjoy all activities to being so limited that it can lead to depression, anxiety, weight gain, and overall decreased satisfaction in all areas of life.”

Why It Happens

Contrary to popular belief, bladder leakage is not limited to women who have experienced childbirth. Although it’s true that childbearing can have what Runnels describes as a “drastic effect on the integrity of the tissue supporting the continence mechanisms,” there are plenty of other factors. Obesity is one. So are things like chronic coughing, anatomic or structural defects, high impact activities, and the natural aging process. Then there are those women who are simply genetically pre-dispositioned to suffer from urinary incontinence.

“The overall incidence in adult women is somewhere between 40-70% depending on the demographic,” says Runnels. “So yes, it is an extremely common problem.”

The Big “O”

While it’s nothing to be embarrassed about, bladder leakage is also not something you have to endure. Depending on the severity of the problem, there are treatment options that range from behavior modifications to medications, in-office pelvic floor physical therapy, surgery, and a relatively new procedure called the O-Shot®. No, it’s not something you order at the bar. It’s a quick, effective, relatively pain-free in-office procedure that not only puts an end to leakage, but it can also improve your sex life. Talk about a win/win!

“The O-Shot® offers a solution that falls in between wearing pads, taking medications, and the more extreme treatments like surgeries,” says Runnels, who explains that it was originally designed to repair sexual dysfunction and enhance sexual function, but was found to have been even better at treating urinary incontinence. “Patients suffering from painful intercourse or lack of difficulty achieving orgasm would come in after having the procedure and say, ‘by the way, I don’t pee on myself anymore.’”

How it Works

Developed by Dr. Charles Runels, the O-Shot® uses the body’s own platelet rich plasma (PRP) to promote significant growth and regeneration of lost tissue in the pelvis surrounding and supporting the urethra. The patient’s blood is drawn and processed in an FDA approved PRP preparation device that separates the white blood cells from the plasma and platelets. The PRP is then injected into two different areas of the vagina to support urinary function.

“The result is a thicker, stronger muscle mucosal tissue and glandular tissue associated with maintaining urinary continence,” explains Runnels, adding that it is important that the PRP prep device is FDA approved and that the provider has been properly trained.

“It can be very dangerous for someone to attempt this procedure using kits that are not created, sterilized, and prepared to support the reinjection of blood components back into the body,” she cautions. “Furthermore, the provider must be licensed by the Cellular Medicine Associates (CMA) to guarantee the procedure is done properly.”

What to Expect

The entire procedure usually takes under an hour and is relatively painless thanks to a topical numbing cream followed by a deeper, injected anesthesia. There is no downtime required and patients can resume all normal activities including exercise and intercourse the same day.

While some patients experience an improvement in leakage on the first day, the longer-lasting effects of the procedure occur approximately three weeks later, with the full effect happening around the nine-to-12-week mark. Results typically last from six months to three years depending on the patient’s aging process, tissue integrity, and lifestyle.

It's Not for Everyone

The O-Shot® is not right for everyone with bladder leakage. According to Runnels, it works best with mild to moderate stress urinary incontinence like that associated with exercise, coughing, or sneezing.

“Patients with severe incontinence or significant structural defects are not likely candidates and may still require traditional surgical repair,” she says.

Women who are not candidates for incontinence issues may still consider the O-Shot® to improve sexual function, especially perimenopausal or menopausal women who may experience significant improvement of vaginal atrophy and dryness from the procedure.

“It can improve the ability, frequency, intensity, and quality of orgasms, as well as improve the feel and function of the vaginal tissues,” explains Runnels. “It can make ‘broken’ sex better and make good sex phenomenal.”

Of course, the only way the O-Shot® works for any treatment is if you speak up. Many women are embarrassed to discuss bladder leakage or sexual issues with their doctors, a problem Runnels hopes to see disappear in the near future.

“Women need to give themselves permission to take care of themselves,” she says adding that when women neglect their own health issues it makes it harder for them to take care of everyone else. “The message here is that women deserve to ask questions and feel like they have a right to do things for themselves that improve their quality of life, especially in the arena of vaginal health, and urinary and sexual function.”

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